Individual provider Active NPI

Amelia Arthur Kobravi, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1942546098
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03967 Issued in NC
Practice address
4909 Green Rd
Raleigh, NC 27616-3418
Phone
(919) 790-0288
NPI assigned
Dec 18, 2012
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03967 NC Primary

Addresses

Primary practice location

4909 Green Rd
Raleigh, NC 27616-3418

Mailing address

4909 Green Rd
Raleigh, NC 27616-3418
Phone (919) 790-0288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131217000786 NC Practitioner - Physician Assistant 2769619840 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care Fuquay PLLCGroup PAC ID 6103258306, 33 clinicians

Practice addresses (Care Compare)

1298 N Main St
Fuquay Varina, NC 27526-2615
Phone (919) 590-4099

2000 S Horner Blvd
Sanford, NC 27330-5818
Phone (919) 352-9538

2200 Treelight Way
Wendell, NC 27591-3200
Phone (919) 374-0900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03967NCMDPhysician Assistant

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1942546098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 GREEN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163418",
            "telephone_number": "919-790-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 GREEN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163418",
            "telephone_number": "919-790-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBRAVI",
        "first_name": "AMELIA",
        "middle_name": "ARTHUR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.